Nortin

Nortin is indicated in Depressive illness, Panic disorder & Neuropathic pain.

Nortriptyline, a dibenzocycloheptadiene tricyclic antidepressant, is the primary active metabolite of amitriptyline. It increases synaptic concentration of serotonin and/or norepinephrine in the CNS by blocking the neuronal reuptake of norepinephrine and serotonin.

Depression, low dose initially increased as necessary to 75-100 mg daily in divided doses or as a single dose (max. 150 mg daily); Adolescent and Elderly patient: 30-50 mg daily in divided doses. Neuropathic pain, initially 10 mg daily at night, gradually increased if necessary to 75 mg daily; higher doses under specialist supervision. Or as directed by the physician.

Administration of reserpine during therapy with a tricyclic antidepressant has been shown to produce a "stimulating" effect in some depressed patients. Close supervision and careful adjustment of the dosage are required when Nortin is used with other anticholinergic drugs and sympathomimetic drugs. Concurrent administration of cimetidine and tricyclic antidepressants can produce clinically. A case of significant hypoglycemia has been reported in a type II diabetic patient maintained on chlorpropamide (250 mg/day), after the addition of Nortin (125 mg/day).

Concurrently treatment with a monoamine oxidase (MAO) inhibitor is contraindicated. Hyperpyretic crises, severe convulsions, and fatalities have occurred when similar tricyclic antidepressants were used in such combinations. It is advisable to have discontinued the MAO inhibitor for at least two weeks before treatment with Nortriptyline is started. Patients hypersensitive to Nortriptyline should not be given the drug. Cross-sensitivity between Nortriptyline and other dibenzazepines is a possibility. It is contraindicated during the acute recovery period after myocardial infarction.

Dry mouth, Constipation, Blurred vision, Tremor, Sedation, Sweating, Rashes, Behavioral disturbances.

Pregnancy category C. Nortriptyline should only be used in pregnancy if considered necessary, taking into account the risks of untreated depression, and under the close supervision of a physician.

Nortin should be used with caution in patients with cardiovascular disease, including heart failure, or arrhythmias. Cardiovascular and ECG monitoring should be undertaken in such patients. When given in high doses patient have been reported to produce QTc prolongation, arrhythmias, sinus tachycardia, and prolongation of the conduction time. Myocardial Infarction and stroke have also been reported with medicines of this class.

Toxic overdosage may result in confusion, restlessness, agitation, vomiting, hyperpyrexia, muscle rigidity, hyperactive reflexes, tachycardia, ECG evidence of impaired conduction, shock, congestive heart failure, stupor, coma, and CNS stimulation with convulsions followed by respiratory depression. Deaths have occurred following overdosage with drugs of this class.

Store in a cool and dry place & protect from light. Keep out of the reach of the children.